Adjustment Disorders

Diagnosis with a chronic illness, divorce, or moving to a new city are all major life changes that can lead to feelings of stress. Usually, these feelings of stress are transient, and people adjust within a few months. However, some people find that they’re having trouble adapting to their changing lives. Adjustment disorder (AD) is a group of stress-related symptoms, including sadness, hopelessness, and feelings of being overwhelmed, that occur when a person is unable to properly cope or adjust to a major life stressor or event. These feelings of stress and other symptoms are disproportionate to the precipitating event.

Adjustment disorder often has many of the symptoms of depressive disorders, such as crying spells, loss of interest in once-enjoyable activities, and feelings of sadness. However, unlike a depressive disorder, adjustment disorder is the result of the influence of an outside stressor and tends to resolve when the person begins to adjust to the situation. The changes in a person’s life become so overwhelming that they lead to serious consequences if left untreated.

There are six sub-types of adjustment disorder that feature a different focus of clinical symptoms. Subtypes of adjustment disorder include:

Adjustment disorder with depressed mood: The symptoms of depression, including loss of self-esteem, low mood, lack of motivation, are the primary complaint.

Adjustment disorder with anxious mood: The predominant symptomatology includes anxiety-related concerns such as excessive worry, feeling overwhelmed, and overarching negative view of possibilities.

Adjustment disorder with mixed anxiety and depressed mood: The symptomatology reflects a combination of depression and anxiety.

Adjustment disorder with disturbance of conduction: Dominating the symptoms are behaviors that break the norms of society or the rights of others such as substance abuse, outbursts of anger, and efforts to seek revenge on others.

Adjustment disorder mixed disturbance of conduct and emotions: The symptoms prevalent in this type of adjustment disorder include emotional symptoms and disturbances of conduct.

Adjustment disorder unspecified: This type of adjustment disorder features maladaptive responses to major life events that do not meet the criteria for other subtypes of adjustment disorder.

The length of time a person who has adjustment disorder experiences the symptoms may vary from person to person. Acute adjustment disorder occurs when a person experiences symptoms for six months or less, before resolution. Chronic adjustment disorder features symptoms longer than six months that cause major disruption in a person’s life. Many people erroneously think that adjustment disorder is less serious than other types of mental health disorders since it involves stress. Adjustment disorders impact a person’s whole life, leading them to suffer in every area of their functioning. Without prompt diagnosis and treatment, adjustment disorder can become a long-term, chronic condition.

Causes and risk factors for adjustment disorder

Adjustment disorder impacts people differently at different ages and can occur at any age. The causes and risk factors for adjustment disorder likely include a complex interplay of genetic, environmental, and physical risk factors working together.

Common types of stressors that can trigger adjustment disorder include:

Risk Factors:

• Other mental health disorders
• Lack of support system
• Difficult life circumstances
• Chronic stressors
• Traumatic events during childhood
• Physical or sexual abuse or assault
• Overprotective or abusive parenting as a child
• Family disruptions as a child
• Frequent moves in early life

Signs and symptoms of adjustment disorder

The symptoms of adjustment disorder do change from person to person, often wildly enough that a diagnosis of adjustment disorder is challenging. The one constant characteristic of adjustment disorder is the symptoms appearing within a certain time period after a major, stressful life event.

Behavioral Symptoms:

• Frequent crying jags
• Fighting with other people
• Being unusually argumentative
• Ignoring bills and other financial obligations
• Avoiding friends, family, and loved ones
• Poor work or school performance
• Being late to work or school frequently
• Excessive absenteeism
• Vandalizing and destroying property

Physical Symptoms:

• Trouble eating
• Changes in sleeping patterns

Cognitive Symptoms:

• Difficulties making decisions
• Trouble concentrating

Psychosocial Symptoms:

• Sadness
• Loss of self-esteem
• Feeling isolated, apart from others
• Hopelessness
• Inability to feel joy or pleasure
• Anxiety and nervousness
• Feeling “on-edge”
• Feelings of being overwhelmed
• Self-harm
• Thoughts of suicide

Effects of adjustment disorder

Left untreated, the effects of adjustment disorder can severely impact a person’s life. Children and teens most especially face long-term complications of adjustment disorder. Some of the most common effects of untreated, chronic adjustment disorder include:

• Depressive disorder
• Anxiety disorders
• Drug or alcohol addiction
• Self-harm
• Suicidal thoughts and behaviors

Treatment for an adjustment disorder

If you’re struggling with adjustment disorder, you’re trying to handle a number of major life stresses or events that have exhausted your ability to cope. Maybe you’ve just moved to a new state and are facing overwhelming obstacles. Perhaps you’re getting a divorce and are struggling with the legal battles, custody hearings, and learning to live life as a single person again. Maybe you’re grieving the loss of a beloved child, parent, or friend and cannot see how you are going to go on without them. You may know that the distress you feel is out of proportion to the event but are unable to simply move past it, no matter how much you’ve tried. The distress you feel about the event or series of events is causing significant impairment in many areas of your life. The stress and distress you’re in makes you feel as though the walls are closing in around you.

We understand the unique challenges of trying to cope with adjustment disorder and are ready to put our decades of experience into your care. 

Types of adjustment disorder treatment

Individual therapy at our office is where you and your therapist will work toward identifying the trigger for the adjustment disorder and discuss more adaptive ways of coping with stress and life events. You’ll set short-term goals for your recovery and begin to identify the patterns of thinking that are negatively impacting your life.

Group therapy can be immensely supportive for people struggling with adjustment disorder. While this is a short-term disorder, the symptoms you experience can be tremendously challenging, and working with a group of people struggling with similar disorders can be a great way to work on social skills, connect with others, learn, grow, and heal.

Family therapy can help you and your loved ones begin to mend any rifts in your relationships and explore any family dynamics which may have contributed to your adjustment disorder. We’ll teach your family ways in which they can support you as you continue to recover from adjustment disorder and allow your loved ones the chance to express their emotions regarding your disorder. We’ll provide referrals to traditional outpatient therapy and community resources to your loved ones as needed.

In our decades of experiencing helping children, teens, adults, and older adults cope with life’s challenges, we’ve learned that combining traditional therapeutic techniques with experiential methods can truly help heal the whole person.

Helping a loved one get treatment for adjustment disorder

If your loved one has been coping with adjustment disorder for the past few months, you know that he or she needs real help and care. While adjustment disorder only persists six or fewer months, it can lead to overwhelming emotional pain for all involved. You may be frustrated with your loved one, unable to understand why they simply can’t move past the stress of the event. You may have tried to help your loved one before, only to have them shut down and tune you out. Here are some tips for gently guiding your loved one into treatment for adjustment disorder:

Learn about adjustment disorder and its treatments: No two people will experience adjustment disorder in the same way. It’s important for you to have a full understanding of what your loved one is going through and how best to help them into treatment. Learn what you can about the disorder, its effects, and effective treatment approaches.

Understand and empathize: It’s very important for you to take the time to recognize and acknowledge that not everyone copes with major life events in the same way. While the event precipitating adjustment disorder may seem inconsequential to you, it’s causing your loved one marked distress. This is the time for empathy, not judgment.